Developmental Problems of Maltreated Children and Early Intervention Options for Maltreated Children. Under-Utilization of Early Intervention Services

04/23/2007

Research on maladaptive functioning and resiliency of maltreated children has contributed to the field of early intervention (Kinard,1998). This research offers evidence of individual and situational protective factors that facilitate child development (Cicchetti & Rogosch, 1997; Haskett, Nears, Ward, McPherson, 2006; Lynskey & Fergusson, 1997). Intervention programs provide positive therapeutic and developmentally enriching experiences that attempt to ameliorate negative effects of maltreatment. It is believed, however, that interventions that occur as early as possible  before developmental delays and behavioral and relational dysfunction become further entrenched  offer the greatest potential for fostering maltreated children's healthy development (Shonkoff & Phillips, 2000).

Under Part C of the Individuals With Disabilities Education Act (IDEA) of 1990, children needing services are to be identified, evaluated, and served, especially those children who are typically underrepresented (e.g., minority, low-income, inner city, Indian and rural populations) through an interagency, coordinated, multidisciplinary system of early intervention services. Each State's early intervention system must include child find and public awareness activities that are coordinated and collaborated with all other child find efforts in the State. Part C recognizes the need for early referral and short timelines for evaluation as development occurs at a more rapid rate during the first three years of life than at any other age.

Children are to be evaluated to determine whether they are eligible for Part C services; however, eligibility requirements vary from state to state. Eligibility for Part C services entitles children to services as deemed necessary in the evaluation and documented in the Individualized Family Service Plan (IFSP) that is developed by Part C service providers and parents at the time the time of enrollment. Physical therapy, occupational therapy, speech and language therapy, and services provided by a developmental specialist, are among the most common Part C services used.

In 2003, the federal government amended the Child Abuse Prevention and Treatment Act (CAPTA) of 1974 through the Keeping Children and Families Safe Act of 2003, which requires states to have provisions and procedures in place for the referral of children younger than the age of 3 years with substantiated maltreatment to Part C. CAPTA does not specifically require that every child younger than the age of 3 who is involved in a substantiated case of child abuse or neglect must be referred to Part C services. States have the discretion to refer every such child younger than the age of 3 for early intervention services or to first use a screening process to determine whether a referral is needed.(2)

Although this vehicle shows promise for better providing intervention services to maltreated infants and toddlers who have documented delays, there is evidence to suggest that Part C and other early intervention programs are underused (Horwitz, Owens, & Simms, 2000; Robinson & Rosenberg, 2004). This underuse is associated with (a) the failure of child welfare professionals to recognize potential developmental problems (which results in low referral rates) and (b) low intervention participation (and high attrition) among parents and guardians (Giardino, Hudson, & Marsh, 2003; Hurlburt et al., 2004).

Endnotes

2.  Part C of the Individuals With Disabilities Education Act (IDEA) of 1990, which was reauthorized on December 3, 2004, by the IDEA Improvement Act of 2004, contains a provision very similar to the one in CAPTA. The conference report accompanying the IDEA legislation indicates that the conferees did not intend the IDEA provision to require every child under the age of 3 who is involved in a substantiated case of child abuse or neglect to receive an evaluation. Rather, the intention was that such children be screened to determine whether a referral to early intervention services is warranted (House Report No. 108-779, 2004).

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